The hidden discrimination faced by people with diabetes

Fifteen in every 100 UK people with diabetes have suffered discrimination and the public needs to improve their understanding of the condition, according to a new publication by the university.

13 October 2014

Latest figures from Diabetes UK show the number of UK people with diabetes has soared to 3.8 million and new strategies are needed to boost their confidence and to help overcome feelings of self-blame and to resist the judgement of others.

Professor Jörg Huber, the university's Professor of Health Sciences, together with Dr Jessica Browne at Deakin University in Australia and Mei Lan Fang (University of Northampton) looked at reviews of literature and interviews with diabetes patients that were carried out in Australia by Dr Browne and colleagues. They looked at the causes of stigma and what can be done to address it. Professor Huber currently is also involved in the development of stigma questionnaires and further research on international dimensions of diabetes stigma.

They found the main source of stigma came from blame and shame: "The poorly-informed stereotype that everyone with Type 2 diabetes is overweight and personally responsible for bringing the condition on themselves is both unhelpful and inaccurate. This reflects a drastically over-simplified picture of the causes of the condition.

"Such judgements put the sole focus on physical inactivity and eating too much of the wrong foods. They completely ignore the other important risk factors such as age and inherited genes, the different reasons why people gain weight, and the many reasons why losing weight and staying physically active can be huge challenges – such as global shifts towards cheaper energy-rich foods and hectic lifestyles that involve less physical demanding work."

One 61-year-old woman interviewed said: "There's this message that diabetes is this terrible thing that terrible people get because they do terrible things."

Stigma for people with Type 2 diabetes (whose pancreas doesn't produce enough insulin) can be equally felt by people with Type 1 diabetes (whose pancreas doesn't produce any insulin). They can feel unfairly "tarnished with the same brush". One 51-year-old man said: "With low blood sugars you get blamed as being irresponsible all the time. 'Why didn't you check your sugar levels before you left?' Sometimes perhaps I forgot or I'm ill prepared, but it's not intentional."

There is also the problem of unwanted pity: "Many people with diabetes want their families, friends, employers and colleagues to understand that diabetes is not a death sentence and having the condition doesn't generally make them sickly, weak or limit their opportunities in life."

Some people with diabetes suffer anxiety about managing their condition in public view – people who test their blood glucose or inject insulin have reported being suspected of using drugs. The media, researchers said, contributed to the stigma by oversimplifying reports.

"One of the most devastating consequences of stigma can be rules, policies and procedures that restrict someone's freedom or lead them to feel excluded or discriminating against – taking part in school or social activities, applying for or holding a job or driving licence, taking a flight or obtaining insurance.

"Stigma and discrimination in the workplace or in personal or romantic relationships can be a particular concern … it can lead to anxiety, frustration, depression, reduced confidence or low self-esteem."

Researchers called for better education about diabetes, from blogs to headlines, to "bust the myths that surround the condition, and improve understanding and acceptance among employers, teachers and the general public.

"In addition, strategies that help people with diabetes to feel confident in themselves and empowered in the strengths and inevitable limitations of their self-care will help them overcome potential feelings of guilt or self blame and resist the judgement of others."

Professor Jörg Huber

One of the most devastating consequences of stigma can be rules, policies and procedures that restrict someone's freedom or lead them to feel excluded or discriminating against – taking part in school or social activities, applying for or holding a job or driving licence, taking a flight or obtaining insurance.